Comparison of After-Hours Emergency Radiology CT Reporting Accuracy by Radiology Trainees at an Australian Level 1...

Many institutions rely on registrar-led after-hours radiology reporting. This study evaluates the after-hours CT reporting discrepancies in a tertiary hospital after transitioning to a subspecialty-based training and reporting system, comparing results from an earlier study in 2014.

A retrospective review of all after-hours CT scans reported by trainees was performed between February 2021 and February 2022. Discrepancies were categorised as either minor or major, and a sub-analysis of the year level of the trainee and time of report was performed.

Out of hours, 22,799 CTs were performed; 18,186 (79.8%) were preliminarily reported by trainees, and 1755 (9.6%) had a consultant addendum. The number of after-hours reports per trainee increased to 909 in 2022 from 859 in 2014 (6% increase). The overall discrepancy rate was 9.6%, 60 major (0.3%) and 1695 minor (9.3%) discrepancies compared to 2014, where there was an overall discrepancy rate of 6.9%, 0.3% major and 6.6% minor. There were no adverse patient outcomes due to any major discrepancy, similar to 2014. The rate of major discrepancies was 0.46% vs. 0.17% (p < 0.00055) and minor 13.9% vs. 3.9% (p < 0.00001) between the junior (1st to 3rd year) and senior trainees (4th to fellows).

The discrepancy rate of trainee after-hours CT reports aligns with the results from other international studies. A move to subspecialty training and reporting resulted in no change in major discrepancy (0.3%) and a slight increase in the minor discrepancy rates (from 6.6% to 9.3%) when compared to results from 2014.